This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Wednesday, 7 July 2010

Job Losses

Thousands of NHS jobs are being cut despite Government promises to protect frontline services, a union has warned. The Royal College of Nursing (RCN) is aware of almost 10,000 posts that have been lost through recruitment freezes, redundancies and people not replaced when they retire, or which face cuts in the future. This is double the figure reported two months ago, although the RCN has now gathered details from more trusts......

I am willing to bet that most of these "job losses" come from qualified nurses at the bedside, providing direct patient care. I know this is the case in my neck of the woods. The trust hires untrained kids who have no intention of becoming Nurses to replace the real Nurses that flee. The kids cannot do the job, and the qualified nurses left are covering too many patients. The trust covers their asses by saying "oh yes we have hired more nurses". They have not hired more nurses, they have hired kids and auxilliaries.

A trusted source tells me that a trust near mine has shed over 70 district nurse posts over the last few years. This trust covers a pretty large area. They lose them through retirement and "natural wastage" and don't replace them. Registered Nurses are an older workforce and most of them are closer the retirement age than not. Newly qualified and job hunting older RN's are having great difficulty finding jobs at the bedside.

19 comments:

Anonymous
said...

Left nursing due to sheer frustration reference just this sort of thing i.e. insubordinate and repeatedly impertinent health care assistant who just cleared off to drink tea in the kitchen whenever she felt like it every time she noticed that I was rushed off my feet. Patients could have had CVAs etc in her absence but she obviously didn't give a damn about them or she wouldn't have done this. Management were informed about her frequent unauthorised absences from the ward but didn't take any steps to discipline her. Why not? Why won't management give nurses support and back up when they need it? (The HCA in question is probably still enjoying her unofficial extra teabreaks to this day and laughing about getting away with it - I just hope none of the patients die due to her selfishness and irresponsibility.

Yeah they won't discipline the cheap labour!! But they witchunt the Nurses. If an HCA does something we are told "but it's your responsibility, you are the nurse-the hca's don't know,etc etc". Yet I have more patients than I can handle.

Someone just informed me that you can go on the NMC website and see cases of Nurses getting struck off due to an HCA's actions. Off to have a look.

Makes for interesting reading. anonymous. Quite how they have come up with the statistic of 2 beds per nurse is a mystery...I assume they are talking about total numbers of nurses per Trust, regardless of whether they are ward based or not. So we want bigger wards and a poorer skill mix eh? Big suprise (not). I have long said that we are heading towards a world where RNs only work in ICU hubs and APs and HCAs work everywhere else. Who cares if the patients suffer- the public purse will be leaner (and meaner).

Unfortunately this is being circulated to Trusts with a view to the principles being seriously considered. Luckily our director of nursing has the final veto on all nursing establishments changes and I know for a fact she won't wear it. She was given this veto earlier this year because our enlightened CEO saw the danger of another Mid Staffs. Judging by this blog, we most be one of the only Trusts in the country increasing our RN establishment, but I am guessing that's because our baseline has been fairly low for many years.

what happened to crippen? UCL Med student would get the whole multidisaplinary team on there: not just nurses. (mind you nurses are the most important people) this is why the consultant always greats me by name at the start of the ward round: but never his collegues who are all doctors. mind you he only asks my opinion at the end of each consultation: i guess if he asked at the begining he wouldnt need to conduct a grand ward round 3 times a day and then he`d have no KUDOS.

Hello there! I know this is somewhat off topic but I was wondering if you knew where I could find a captcha plugin for my comment form?I'm using the same blog platform as yours and I'm having trouble finding one? Thanks a lot!

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.